The Nintendo Wii Balance Board may be making positive changes in brain connections linked to balance and movement in people with multiple sclerosis, according to new research in the journal Radiology. The accessory for the popular Wii video game console was used along with Magnetic resonance imaging (MRI) scans for this finding.
One of the most common and disabling symptoms of multiple sclerosis (MS) is balance impairment. MS is a disease of the central nervous system in which the body’s immune system attacks the protective sheath around nerve fibers.
Wii Improvements in Balance
Physical rehabilitation is often used to preserve balance, and one of the more promising new tools is the Wii Balance Board System, a battery-powered device about the size and shape of a bathroom scale. Users stand on the board and shift their weight as they follow the action on the television screen during games like slalom skiing.
Although Wii balance board therapy has been reported before this as being effective in patients with MS, not much is known about the underlying physiological basis for any improvements in balance.
Using an MRI technique called diffusion tensor imaging (DTI), researchers studied changes in the brains of 27 MS patients. The patients underwent a 12-week rehabilitation using Wii balance board-based visual feedback training.
Diffusion tensor imaging is an unconventional MRI technique allowing detailed analysis of the white matter tracts transmitting neurological signals through the brain and body.
MRI scans of the MS patients revealed considerable effects in nerve tracts important to balance and movement. The changes seen on MRI correlated with improvements in balance as measured by an assessment technique called posturography.
These brain changes in MS patients are thought to be an expression of neural plasticity. Neural plasticity is the brain’s ability to adapt and form new connections throughout life, said lead author Luca Prosperini, M.D., Ph.D.
“The most important finding in this study is that a task-oriented and repetitive training aimed at managing a specific symptom is highly effective and induces brain plasticity,” Prosperini said. “More specifically, the improvements promoted by the Wii balance board can reduce the risk of accidental falls in patients with MS, thereby reducing the risk of fall-related comorbidities like trauma and fractures.”
Dr. Prosperini added that comparable plasticity has been described in persons who play video games, but the exact mechanisms behind the phenomenon are still unknown. He hypothesized that changes can occur at the cellular level within the brain and may be related to myelination, the process of building the protective myelin sheath around the nerves.
“This finding should have an important impact on the rehabilitation process of patients, suggesting that they need ongoing exercises to maintain good performance in daily living activities,” Dr. Prosperini said.
The rehabilitation-induced improvements did not continue after the patients stopped the training protocol, Dr. Prosperini explained, presumably because certain skills related to structural changes in the brain after an injury need to be maintained through training.
Luca Prosperini M.D., Ph.D., Fulvia Fanelli, M.D., Nikolaos Petsas, M.D., Ph.D., Emilia Sbardella, M.D., Ph.D., Francesca Tona, M.D., Eytan Raz, M.D., Deborah Fortuna, M.S., Floriana De Angelis, M.D., Carlo Pozzilli, M.D., Ph.D., and Patrizia Pantano, M.D.
Multiple Sclerosis: Changes in Microarchitecture of White Matter Tracts after Training with a Video Game Balance Board.
Radiology, August 2014 DOI: http://dx.doi.org/10.1148/radiol.14140168